Radiculopathy - pinched nerve in the neck or back
Radiculopathy - pinched nerve in the neck or back
Condition
This means ‘disease of the nerve root’ which is often caused by pressure on the nerve as it leaves the spine. There are, however, medical conditions which can cause this. It is a symptom and does not describe the underlying problem.
The pressure is usually caused by a slipped disc or other degenerative changes of the bones close to the nerve (i.e. facet joints). In the leg, this is also called 'sciatica', in the arm 'brachialgia'. It can also be caused by infection or tumours. Radiculopathy can affect any nerve leaving the spine (neck, thoracic spine and lower back) but is most common in the lower neck and lower back. It is rare in the thoracic spine but can feel similar to pain originating in other organs like the heart (angina), kidneys (kidney stones) or gallbladder (gallstones). However, the pain is often sharp and shooting or like an electric shock. In the chest it feels like a band around one or sometimes both sides along a rib. If there has been nerve damage due to the pressure it can feel like a burning pain.
Symptoms
Pressure on a nerve can cause three different symptoms:
- Pain
- Pins and needles or numbness in the area of skin and weakness of the muscles supplied by the nerve. In most cases it starts with pain followed by pins and needles.
- Weakness can also be due to pain itself in which case it is often more widespread and not just limited to the muscles supplied by the nerve.
Complications
Permanent numbness or weakness of the arm/ hand or neuropathic pain due to nerve damage.
Investigations
Unless the pain is transient and quickly improves, an MRI scan is indicated to see whether there is any pressure on the nerve roots. Neurophysiological investigations might also be indicated if the MRI is inconclusive or if pressure on a nerve in the arm or leg itself is suspected.
Treatment and Outlook
This depends on the underlying condition. In principle, nerve pain caused by pressure usually improves over time without intervention if the slipped disc resolves. Progressive numbness and weakness should be treated if there is underlying compression and usually responds well to surgical decompression. Mild to moderate numbness or weakness often improves or even resolves but this depends on the severity and duration of compression and the underlying condition.